Travelers may have been exposed to measles at Disneyland — Here’s how to keep your family safe23rd October 2019
On Oct. 16, a person with measles traveled to Disneyland while infectious, according to the Los Angeles Times. Anyone who was at Disneyland between 9:15 a.m. and 8:35 p.m. may have been exposed, and could develop measles within 21 days of exposure.
This is just the latest report of travelers being exposed to measles. By Oct. 3, the Centers for Disease Control (CDC) had recorded 1,250 individual cases of measles across 31 states this year — the highest number in the nation since 1992.
In May, a cruise ship in St. Lucia was quarantined after a case of measles was confirmed on board, and there have been multiple measles reports at major U.S. airports including Los Angeles (LAX), Chicago (MDW) and Newark Liberty (EWR).
Outside of the U.S., measles has remained a common disease in some areas of the world. The CDC indicates that 10 million people around the world get measles annually, and about 110,000 of them die from the disease.
Given the increase in measles outbreaks, it’s important for travelers, and especially families, to know how to stay safe during a measles outbreak.
What you need to know about the measles
Measles is an airborne disease, spread from coughing and sneezing, and can linger up to two hours. Symptoms — which according to the CDC often manifest with seven to 14 days from exposure — typically include a high fever, cough, runny nose and red and watery eyes. The signature measles rash usually manifests itself three to five days after these symptoms surface. Those who have measles can spread the infection during a roughly eight-day window — four days before the rash appears, and another four days after.
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Dr. Nava Yeganeh, a pediatrician and infectious disease specialist at Ronald Reagan UCLA Medical Center, pointed out that measles is more infectious than Ebola. “It has a really high degree of infectivity. One person with measles might infect up to 18 others, whereas one person with Ebola usually infects two to three individuals.”
She adds that families are “wise to be cautious” because the effects of the disease are much more scary for children.
“Measles is often much more devastating in younger children,” said Dr. Yeganeh. “Children with measles suffer more of the complications, such as pneumonia and encephalitis. If you get measles when you’re under the age of 1, there’s a 1-in-600 chance you might develop a fatal chronic brain inflammation disorder called subacute sclerosing panencephalitis (SSPE).”
Fortunately, said Dr. Jon Sutter of Nuheights Pediatrics in Clifton, New Jersey, the MMR (measles, mumps and rubella) vaccine is an effective way of avoiding the disease altogether and he strongly advises following established recommended schedules for vaccination. Two shots of the MMR vaccine are 97% effective against measles, and children who have those two doses enjoy lifetime protection against the disease.
Should babies who travel get the measles shot early?
If international travel is on the docket, the CDC recommends that infants 6 to 11 months of age should have one dose of measles vaccine (usually, children in the U.S. receive this first dose between 12 and 15 months of age).
Also, the CDC recommends that any infant vaccinated before 12 months of age should also be revaccinated on or after the first birthday with two doses, separated by at least 28 days. Dr. Yeganeh added that travel should wait until after the antibodies have had a chance to form, which typically takes two to three weeks.
Should preschoolers get the measles booster early?
Typically, children in the U.S. get the booster MMR shot between 4 and 6 years of age, but an accelerated schedule after the first birthday of two doses separated by at least 28 days is recommended by the CDC if you’re planning travel abroad, especially to countries on the CDC watchlist.
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The doctor’s prescription
Here’s the first piece of advice when trying to decide how to handle the measles vaccine for your family: Don’t panic.
Dr. Louis Morledge, a New York City-based internist with a specialty in travel medicine, advises families to first review their itinerary. “If they are going to areas that the CDC has labeled on the watchlist, then I would exhibit a lot of caution with regards to traveling with young children who are pre-vaccination age.”
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Morledge pointed out that families need not avoid travel altogether — or overreact to headlines.
“Yes, there are more cases in the U.S. since the year 2000, and the number will probably only increase,” Morledge said. “But at the same time, this is a very small percentage of people that are affected and, for the most part, they’ve been in select communities where there are a lot of non-vaccinators.”
Morledge does not see a reason to accelerate vaccination schedules if families are not traveling to areas with outbreaks as announced by the CDC.
He does add that, because the situation on the ground changes so often, families should consult their state health departments before proceeding.
Parents who are traveling with their kids should also check on their vaccinations, Morledge advised. “If an adult doesn’t know [his or her] vaccination status and they’re traveling with young children, they should find out about their immunity status with a blood test that gives this information.” Lost immunity would signal that the adult should get vaccinated, too.
Finally, said Yeganeh, don’t forget the importance of basic hygiene, including washing hands and exercising caution, especially in public places.
Yes, the U.S. is grappling with a measles outbreak at a level that outpaces recent years. The exact recommendations for families when it comes to accelerated measles vaccination schedules differs a bit depending on who you consult, but the doctors agree that a little common sense and following CDC- and doctor-prescribed strategies are key.
In the end, you need to determine what is right for your family. That may mean vaccinating early, avoiding certain countries or locations with current measles outbreaks until children are fully vaccinated, or doing nothing differently at all. You (and perhaps your physicians) need to make the decision you’re most comfortable with to keep your family as healthy as possible for the long haul.
Additional reporting by Melanie Lieberman.
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